Characteristics of patients with ADs admitted to the ICU
| Characteristic | Total n=50 | Survivors | No survivors | p Value | OR (95% CI) |
|---|---|---|---|---|---|
| n=38 (76%) | n=12 (24%) | ||||
| Age (years) | 46.7±17.55 | 46.23± 18.58 | 48.17±14.39 | NS | |
| Gender, female (%) | 39 (78%) | 30 (78.9%) | 9 (75%) | NS | |
| Length of hospital stay before ICU (days) | 6.82±9.61 | 4.65±8.13 | 13.67±11.03 | 0.002 | |
| Length of ICU stay (days) | 10.96±11.06 | 11.5±11.85 | 9.25±8.29 | NS | |
| Re-entry ICU | 6 (12%) | 5 (13.16%) | 1 (8.33%) | NS | |
| Death during ICU stay | 12 (24%) | – | – | ||
| Death during hospitalisation after ICU | 4 (8%) | 4 (10.5%) | – | ||
| Hospital readmission | 5 (10%) | 5 (13.2%) | – | ||
| AD-related factors | |||||
| Duration of AD (months)* | 49.43±79.48 | 47.75±84.79 | 54.91±62.02 | 0.3822 | |
| New diagnosis | 11 (22%) | 8 (22.2%) | 3 (25%) | NS | |
| Previous comorbidity | |||||
| No disease background | 16 (32%) | 12 (31.6%) | 4 (33.3%) | NS | |
| New diagnosis AD | 5 (31.25%) | 4 (33.3%) | 1 (25%) | NS | |
| Previously diagnosis AD | 11 (68.75%) | 8 (66.7%) | 3 (75%) | NS | |
| Cardio and cerebrovascular disease | 18 (36%) | 15 (39.5%) | 3 (25%) | NS | |
| Chronic kidney disease | 13 (26%) | 12 (31.6%) | 1 (8.3%) | NS | |
| Prior immunosuppressant within 3 months | |||||
| No pharmacology background | 15 (30%) | 12 (31,6%) | 3 (25%) | NS | |
| Steroids | 33 (66%) | 24 (63.2%) | 9 (75%) | NS | |
| Other immunosuppressors† | 22 (44%) | 15 (39.5%) | 7 (58.3%) | NS | |
| ICU parameters | |||||
| APACHE II (n=42) | 14.07±7.02 | 13.53±7.47 | 15.8±5.25 | 0.2737 | |
| ODIN score | 2.48±1.57 | 2.26±1.52 | 3.18±1.59 | 0.1041 | |
| Glasgow score | 12.94±3.21 | 13.65±2.48 | 10.67±4.21 | 0.043 | |
| Severe Glasgow score‡ | 7 (14%) | 2 (5.26%) | 5 (41.6%) | 0.005 | 11.5 (1.71 to 77.18) |
| Complication during ICU stay§ | 7 (14%) | 2 (5.3%) | 5 (41.7%) | 0.002 | 7.50 (1.97 to 57.96) |
| MV | 26 (52%) | 15 (39.5%) | 11 (91.67%) | 0.002 | 7.91 (1.88 to 71.61) |
| # days MV | 4.24±8.49 | 3.53±8.53 | 6.5±8.32 | 0.037 | |
| Dialysis | 11 (22%) | 10 (26.3%)¶ | 1 (8.3%) | NS | |
| CPR | 13 (26%) | 2 (5.3%) | 11 (91.7%) | <10−4 | 66.0 (13.30 to 948.89) |
| Transfusion | 35 (70%) | 24 (63.2%) | 11 (91.7%) | NS | |
| Vasopressor support | 26 (52%) | 16 (42.1%) | 10 (83.3%) | 0.013 | 4.31 (1.25 to 26.14) |
| Shock | 26 (52%) | 16 (42.1%) | 10 (83.3%) | 0.013 | 4.31 (1.25 to 26.14) |
| Alveolar haemorrhage | 10 (20%) | 9 (23.7%) | 1 (8.3%) | NS | |
| IVIG ICU | 19 (38%) | 16 (42.1%) | 3 (25%) | NS | |
| Plasmapheresis ICU | 10 (20%) | 5 (13.2%) | 5 (41.7%) | 0.031 | 3.44 (1.07 to 18.52) |
| ICU support NCV (n=38)** | 14 (36.8%) | 3 (11.5%) | 11 (91.6%) | <10−4 | 31.63 (6.70 to 395.34) |
| Infections | |||||
| Sepsis | 33 (66%) | 24 (63.2%) | 9 (75%) | NS | |
| Septic shock | 18 (36%) | 11 (28.9%) | 7 (58.3%) | NS | |
| With no pharmacology background†† | 9 (27.28%) | 6 (25%) | 3 (25%) | NS | |
| With pharmacology background‡‡ | 24 (72.72%) | 18 (75%) | 6 (66.7%) | NS | |
| Urinary sepsis§§ | 19 (38%) | 14 (36.8%) | 5 (41.6%) | NS | |
| Lung sepsis§§ | 10 (20%) | 7 (18.4%) | 3 (25%) | NS | |
| Abdominal sepsis | 5 (10%) | 1 (2.63%) | 4 (33.3%) | 0.002 | 8.22 (1.80 to 97.04) |
The continuous variables are represented with mean±SD and the categorical variables are represented with frequency (percentage); p value presented corresponds to survivor and no-survivor comparison.
*Data not available for three patients.
†Other immunosuppressors (ie, DMARDs, antimalarial, azathioprine, cyclophosphamide, mycophenolate mofetil, anti-TNF).
‡Severe Glasgow score was defined as a score of ≤8 in Glasgow during ICU admission. §Complications during ICU stay excluding infection or AD.
¶Hospital discharge with dialysis in seven patients (18.4%).
**Need any of ICU support grouped in clusters: ICU support G1 compared with ICU support G3.
††Those are the patients with sepsis who does not have rheumatological pharmacology background in the past 3 months.
‡‡Patients with any rheumatological pharmacology background in the past 3 months. §§One patient has two source of sepsis (urinary and lung).
¶¶Time related with ICU stay: G1 compared with G3 (see Figure 1).
AD, Autoimmune disease. APACHE II, Acute Physiology and Chronic Health Evaluation II score. CPR, cardiopulmonary resuscitation. DMARDs, Disease-modifying antirheumatic drugs. ICU, Intensive care unit. IVIG, intravenous IgG; MV, Mechanical ventilation; NCV, new cluster variable; NS, not significant; ODIN, organ dysfunctions and/or infection; TNF, tumour necrosis factor.